Serum Cr Concentrations Research Articles

Acute Effect of Three Aerobic Exercise Intensities on Glomerular Filtration Rate in Healthy Older Adults.

To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Eighteen healthy, sedentary older adults (ten men and eight women) voluntarily participated in this study. The participants underwent three standardized aerobic exercise tests (100%, 80%, and 60% of the maximal heart rate) on a bicycle ergometer. Blood samples were collected to determine cholesterol, triacylglycerols, glucose, serum creatinine (Cr), Cystatin C (CysC) concentrations, and eGFR. eGFR and serum concentrations of Cr and CysC were not modified at any exercise intensity. There was a negative correlation between blood total cholesterol vs. eGFR (R = -0.512, R = -0.582, R = -0.531; p < 0.05) at rest, 60%, and 100% of the maximal heart rate, respectively. In addition, a negative correlation existed for age vs. eGFR at 60% of the maximal heart rate (R = -0.516; p < 0.05). Short-duration aerobic exercise of low, moderate, and vigorous intensity did not significantly affect eGFR and is considered safe for kidney function in healthy, sedentary older adults. However, regular monitoring of kidney function in older people engaged in moderate- and high-intensity exercise is advised.

Effect of tea polyphenol-trehalose complex coating solutions on physiological stress and flesh quality of marine-cultured Turbot Scophthalmus maximus during waterless transport.

The waterless transport of live fish has changed the present situation of live-fish transport. However, the waterless transport environment may cause stress in fish. This research evaluated the effect of tea polyphenol-trehalose (TPT) coating solutions on Turbot Scophthalmus maximus during waterless transport. After cold acclimation, Turbot were coated and subsequently transported in a waterless environment for 18 h. Physiological and biochemical parameters were measured, including lysozyme (LZM) and immunoglobulin M (IgM) activities, serum creatinine (Cr) and uric acid (UA) concentrations, and nutritional flavor. The results showed that the nonspecific immunity of Turbot was inhibited during the waterless transport; the LZM activity first increased and then decreased, and the serum Cr and UA concentrations significantly increased. In addition, the waterless transport promoted the breakdown of Turbot flesh proteins, leading to changes in nucleotides and free amino acids (FAAs). After waterless transport, the LZM and IgM activities in the TPT-treated Turbot were higher than those in the control group (CK), and the changes in FAA content and nucleotides were smaller than those observed in the CK group. This study shows that the use of TPT coating solution can reduce the impact of waterless transportation stress on the immune and metabolic functions of Turbot and can maintain the meat quality and flavor of Turbot.

Relationship between the serum creatinine concentrations of preterm neonates within 24h of birth and their mothers before delivery.

Neonatal serum creatinine (n-sCr) concentrations during the first few days of life have been reported to correlate with the maternal serum Cr (m-sCr) concentrations. We aimed to derive a regression equation to describe the relationship between n-sCr within 24h of birth in preterm neonates and m-sCr before delivery, and to perform multiple regression analysis to identify factors related to n-sCr and the difference between n-sCr and m-sCr. We recruited preterm neonates who were treated at the University of the Ryukyus Hospital between March 2012 and October 2022. Patients with underlying diseases or conditions that might affect hemodynamics were excluded, as were patients whose n-sCr and m-sCr were not measured in pairs. A total of 278 cases were included in the analysis. The median (interquartile range) gestational age, birth weight, n-sCr, and m-sCr were 33.9weeks (32.0-35.1weeks), 1901g (1579-2284g), 0.55mg/dL (0.48-0.64mg/dL), and 0.47mg/dL (0.42-0.57mg/dL), respectively. The regression equation derived was n-sCr = 0.092 + 0.970 × m-sCr (R2 = 0.768, p < 0.001). The multiple regression analysis showed that m-sCr was the most potent influencer of n-sCr, and the ratio of placental weight to birth weight (PW/BW ratio) was the most potent influencer of the difference between n-sCr and m-sCr. We have obtained an approximate equation of n-sCr = 0.1 + m-sCr for preterm neonates. In addition, the high PW/BW ration may reduce the difference between n-sCr and m-sCr.

Does the peroral chromium administration in young Hariana calves reduce the risk of calf diarrhea by ameliorating insulin response, lactose intolerance, antioxidant status, and immune response?

BackgroundThe reduction in insulin sensitivity during rumen development may predispose dairy calves towards lactose intolerance, which could be the reason behind neonatal calf diarrhea (NCD). Chromium (Cr) results in a range of effects when fed to ruminants, but most studies have shown improved insulin sensitivity. The aim of this study was to determine the effect of Cr supplementation on insulin sensitivity, lactose intolerance, diarrhoea and antioxidant, and immune response in young Hariana calves. MethodsA total of 20 milk-fed Hariana calves were randomly assigned to 1 of 2 treatments, each consisted of 10 calves: (1) a control group without supplemental Cr and (2) a 0.15 mg Cr as Cr-picolinate (CrPic)/kg BW0.75 supplemented group (Cr0.15). ResultsA more rapid glucose disappearance with unaltered insulin kinetics during intravenous glucose tolerance test (IVGTT) and oral lactose tolerance test (OLTT) indicates greater insulin sensitivity in Cr supplemented calves. Better insulin sensitivity in Cr supplemented calves was further confirmed by higher values of the quantitative insulin sensitivity check index (QUICKI), revised quantitative insulin sensitivity check index (RQUICKI) and insulin receptor substrate-1 (IRS-1) and lower (P < 0.05) values of homeostasis model assessment-insulin resistance (HOMA-IR) and glucose-to-insulin ratio in Cr supplemented calves during IVGTT. Cr supplementation resulted in a lower (P < 0.05) serum cortisol concentration, whereas serum non-esterified fatty acid (NEFA) concentrations during IVGTT did not differ among the groups. The rise in serum glucose concentrations within 2 h post lactose infusion during OLTT peaked at more than twice the basal glucose concentration, therefore calves were not considered as lactose intolerant. Within monthly blood samples, concentrations of serum insulin were similar among treatments, whereas the Cr supplemented group had lower (P < 0.05) serum glucose concentration and glucose-to-insulin ratio compared with the control group. No treatment differences were detected in the biomarkers of antioxidant status and immunity. Serum Cr concentrations were higher (P < 0.05) in Cr supplemented calves while concentrations of other studied minerals were remained unaltered. The incidence, duration of diarrhea, and faecal score were better (P < 0.05) in calves fed on Cr supplemented diet whereas, no treatment effect was observed on average daily gain (ADG). During the study period, no calves died, and no calves were found to have pneumonia, navel or joint disease. ConclusionFeeding a Cr-supplemented diet improved insulin sensitivity and reduced the risk of diarrhoea in milk-fed young calves, but had no or minimal effects on lactose intolerance, antioxidant status, immune response, and growth performance.

Serum cystatin C and inflammatory factors related to COVID-19 consequences

BackgroundBesides impaired respiratory function and immune system, COVID-19 can affect renal function from elevated blood urea nitrogen (BUN) or serum creatinine (sCr) levels to acute kidney injury (AKI) and renal failure. This study aims to investigate the relationship between Cystatin C and other inflammatory factors with the consequences of COVID-19.MethodsA total of 125 patients with confirmed Covid-19 pneumonia were recruited in this cross-sectional study from March 2021 to May 2022 at Firoozgar educational hospital in Tehran, Iran. Lymphopenia was an absolute lymphocyte count of less than 1.5 × 109/L. AKI was identified as elevated serum Cr concentration or reduced urine output. Pulmonary consequences were evaluated. Mortality was recorded in the hospital one and three months after discharge. The effect of baseline biochemical and inflammatory factors on odds of death was examined. SPSS, version 26, was used for all analyses. P-vale less than 0.05 was considered significant.ResultsThe highest amount of co-morbidities was attributed to COPD (31%; n = 39), dyslipidemia and hypertension (27%; n = 34 for each) and diabetes (25%; n = 31). The mean baseline cystatin C level was 1.42 ± 0.93 mg/L, baseline creatinine was 1.38 ± 0.86 mg/L, and baseline NLR was 6.17 ± 4.50. Baseline cystatin C level had a direct and highly significant linear relationship with baseline creatinine level of patients (P < 0.001; r: 0.926). ). The average score of the severity of lung involvement was 31.42 ± 10.80. There is a direct and highly significant linear relationship between baseline cystatin C level and lung involvement severity score (r = 0.890, P < 0.001). Cystatin C has a higher diagnostic power in predicting the severity of lung involvement (B = 3.88 ± 1.74, p = 0.026). The mean baseline cystatin C level in patients with AKI was 2.41 ± 1.43 mg/L and significantly higher than patients without AKI (P > 0.001). 34.4% (n = 43) of patients expired in the hospital, and the mean baseline cystatin C level of this group of patients was 1.58 ± 0.90 mg/L which was significantly higher than other patients (1.35 ± 0.94 mg/L, P = 0.002).Conclusioncystatin C and other inflammatory factors such as ferritin, LDH and CRP can help the physician predict the consequences of COVID-19. Timely diagnosis of these factors can help reduce the complications of COVID-19 and better treat this disease. More studies on the consequences of COVID-19 and knowing the related factors will help treat the disease as well as possible.

Association between Serum Cys C and PTB Cavitation.

Cystatin C (Cys C) not only regulates the body's immune defenses but also contributes to tissue degradation and destruction by causing an imbalance between protease and antiprotease in infectious diseases. Is Cys C involved in pulmonary tuberculosis (PTB) infection and cavitation? We therefore conducted a retrospective study on this question to provide a basis for further studies. Cavitary PTB patients, noncavitary PTB patients, and healthy controls were recruited in our study. Serum Cys C, CRP, BUN, UA, and CR were measured in all subjects, and the Kruskal-Wallis test was used to compare medians of these clinical parameters in different groups. The Spearman rank correlation test was used to determine correlations between variables. In addition, a multivariate analysis using binary logistic regression was used to identify factors associated with PTB cavitation. In our study, elevated serum Cys C levels were found in cavitary PTB patients compared to healthy controls and noncavitary patients (p = 0.022). Serum Cys C levels were statistically correlated with serum BUN and CR concentrations (r = 0.278, p = 0.005; r = 0.281, p = 0.004) in PTB patients. The binary logistic regression analysis showed that elevated serum Cys C levels were correlated with pulmonary cavitation in PTB patients (OR = 1.426, 95% CI: 1.071-1.898). Elevated serum levels of Cys C are associated with pulmonary cavitation in PTB patients.

Haemodialysis alters the serum metal contents in chronic kidney failure patients at hyderabad and adjoining areas.

Present study aimed to explore alterations of serum metal contents in patients of chronic kidney disease before and after haemodialysis (HD) compared to controls. For the levels of heavy metals in serum samples of kidney patients before and after HD belonging to different areas of Hyderabad and adjoining areas admitted atdifferent hospitals of Hyderabad. In this study, the level of copper (Cu), zinc (Zn), chromium (Cr), iron (Fe) and manganese (Mn) in serum sample of kidney patients and controls have been investigated using Atomic Absorption Spectrophotometer (AAS). An increase in serum urea and serum creatinine levels in patients with chronic kidney disease (CKD) when compared to controls was observed and it was due to the decreased glomerular filtration in patients with CKD. The average of serum Cu and Cr were significantly high in pre-HD patients as compared to controls, reverse was found just in case of Mn and Fe. Serum Cu and Mn were significantly increased in post-HD patients when put next to the controls, whereas, serum Cr concentration was significantly decreased after HD in comparison to the controls. Concentration of serum Cu, Fe and Mn were significantly increased in post-HD patients as compared to the pre-HD patients. In conclusion, hemodialysis alters the serum metal contents in CKD patients. After the study, it is suggested that, serum metal contents before the dialysis session must be investigated more extensively to elucidate the alterations throughout the dialysis session and may be medicated accordingly.

Elevated concentrations of chromium in maternal serum, umbilical cord serum, and cord tissue are associated with an increased risk for orofacial clefts

Chromium (Cr) exposure during gestation causes malformations in animal experiments. In this multicenter case–control study, we initially involved 130 orofacial clefts (OFCs) and 260 controls to assess the association between Cr concentration and risk for OFCs. Then, umbilical cord serum (49 vs. 119) and cord tissue (84 vs. 142) were used to validate the association between Cr and OFCs. We found that maternal serum Cr concentrations in OFC cases were significantly higher than those in controls. Compared with the lowest tertile of maternal serum Cr concentration, the highest tertile of Cr increased the risk for OFCs [OR = 2.14 (1.14–4.05)]. In the validation cohort of umbilical cord serum and tissue, higher concentrations of Cr were associated with increased risks for OFCs in a dose-dependent manner (all Ps for trends <0.05). Cr concentrations in maternal serum and cord serum showed a positive correlation. The Cr concentration in cord serum was inversely correlated with egg and milk consumption frequencies, and the Cr concentration in cord tissue was positively associated with indoor coal burning. In conclusion, prenatal Cr exposure is a risk factor for OFCs, and indoor coal burning during pregnancy may be one of the sources of Cr exposure.

Cross-sectional study: Relationship between serum trace elements and hypertension

BackgroundA balanced intake of trace elements is beneficial for chronic diseases such as hypertension. However, the available information regarding trace elements that may be independently associated with hypertension is limited, and the relationship between this disorder and element ratios also remains unclear. MethodsA total of 6,754 subjects from rural China were selected, after exclusion of patients who were under 18, had incomplete data or had additional related disorders, by multi-stage simple random and cluster sampling (participation rate: 95.22 %). Subjects were divided into a hypertensive (H) and a control (C) group. Data were collected on blood pressure and 12 serum trace elements were measured by flame atomic absorption spectrometry and inductively coupled plasma-mass spectrometry. Other basic information was collated from questionnaires and biochemical indicators were measured via kits. ResultsDifferences in serum levels of magnesium (Mg(mg/l): H: 27.43 ± 12.72; C: 26.33 ± 12.16), iron (Fe(mg/l): H: 1.99 ± 1.24; C: 1.84 ± 1.16), copper (Cu(mg/l): H: 1.19 ± 0.37; C: 1.10 ± 0.36), boron (B(μg/l): H: 50.00 ± 25.21; C: 47.57 ± 26.25), selenium (Se(μg/l): H: 125.12 ± 32.81; C: 118.80 ± 29.72) and chromium (Cr(μg/l): H: 8.77 ± 10.12; C: 10.12 ± 10.72) between the hypertensive and control groups were found. There were no differences in serum contents of calcium (Ca(mg/l): H: 112.43 ± 58.25; C: 111.00 ± 59.49), zinc (Zn(mg/l): H: 1.50 ± 1.97; C: 1.44 ± 1.88), arsenic (As(μg/l): H: 4.17 ± 3.94; C: 4.10 ± 4.00), manganese (Mn(μg/l): H: 4.15 ± 4.03; C: 4.07 ± 4.05), cadmium (Cd(μg/l): H: 1.14 ± 1.11; C: 1.18 ± 1.12) or lead (Pb(μg/l): H: 4.22 ± 8.90; C: 4.26 ± 10.25). The serum Cr and Cd concentrations of hypertensive men were lower than that of male controls while Mg, Cu, Ca and Se concentrations in male controls were lower. Further differences were apparent and Fe, B, Se, Mg and Cu all showed higher levels in hypertensive females whereas Cr concentrations were higher in female controls. Serum Zn and B levels showed age-related variations among hypertensive patients and concentrations of serum Cu, Zn, Se and B showed age-related variations among control subjects. For hypertensive patients, the odds ratio (OR) and 95 % confidence interval (CI) for the association of serum Cu, Se and Cr levels with hypertension were Cu: 1.36 (1.12–1.66); Se: 1.03 (1.01–1.05); Cr: 0.89 (0.83−0.96). Moreover, when the participants in the grouping with the highest copper/zinc (Cu/Zn) and magnesium/manganese (Mg/Mn) ratios were compared with the reference group, the OR and 95 % CI for hypertension were 1.22 (1.04–1.44) and 1.20 (1.01–1.42), respectively. ConclusionsLevels of serum trace elements showed age- and sex-related differences in a group of rural Chinese adults with hypertension and healthy participants. Serum concentrations of Cu, Se and Cr may be independently associated with hypertension. Higher serum ratios of Cu:Zn and Mg:Mn may also be associated with hypertension. Further randomized trials are necessary to elucidate the true relationship between levels of Cu, Se, Cr, Cu:Zn, Mg:Mn and hypertension.

Accuracy of Urea Nitrogen and Creatinine Measurements in Postmortem Serum and Pericardial Fluid Compared With Antemortem Data.

Although several studies have measured urea nitrogen (UN) and creatinine (Cr) concentrations in postmortem serum and pericardial fluid, no recent antemortem biochemical data have been available for forensic autopsy, thereby making the evaluation of the accuracy of postmortem data difficult. This study compared antemortem (from emergency room results before the declaration of death) and postmortem serum UN and Cr concentrations, as well as postmortem serum and pericardial fluid values, in 51 forensic autopsy cases (postmortem interval within 87 hours). Postmortem UN concentrations were strongly correlated with antemortem data. Moreover, no significant difference between pericardial fluid UN concentrations and antemortem data was observed. Postmortem serum and pericardial fluid Cr values were also correlated with antemortem data, although postmortem values were significantly higher than antemortem ones. Given our observation of early postmortem elevation in Cr concentrations, such an elevation was attributed to rigor mortis. In conclusion, the current study demonstrated the utility of postmortem UN and Cr concentrations, in particular of those measured in the pericardial fluid.

MO419THE ROLE OF SHORT-TERM, HIGH-DOSE ATORVASTATIN FOR PREVENTION OF CONTRAST-INDUCED ACUTE KIDNEY INJURY (CI-AKI) IN PATIENTS WITH CARDIOVASCULAR DISEASES UNDERGOING COMPUTED TOMOGRAPHY WITH INTRAVENOUS CONTRAST ADMINISTRATION

Abstract Background and Aims Computed tomography with intravenous contrast media is widely used in hospitals. The incidence of CI-AKI due to intravenous contrast media administration in high-risk patients remains not studied as well as CI-AKI after intraarterial contrast media administration is. According to other researchers, the use of statins in the prevention of AKI after intra-arterial administration of a contrast agent is currently considered an efficient preventive measure. The aim of our study is to assess the incidence of contrast-induced acute kidney injury in patients with cardiovascular diseases during CT scan with intravenous contrast media and analyze the efficacy and safety of various statin dosing regimens for prevention of CI-AKI. Method A randomized controlled open prospective study is planned. Statin naive patients with cardiovascular diseases will be divided into 3 groups. Patients in the first group will receive atorvastatin 80mg 24 hours and 40mg 2 hours before CT scans and 40 mg after. The second group – 40 mg 2 hours before CT scans and 40 mg after. A third group is a control group. Exclusion criteria were current or previous statin treatment, contraindications to statins, severe renal failure, acute coronary syndrome, administration of nephrotoxic drugs. The primary endpoint will the development of CI-AKI, defined as an increase in serum Cr concentration 0.5 mg/dl (44.2 mmol/l) or 25% above baseline at 72 h after exposure to the contrast media. Results We assume a higher incidence of contrast-induced acute kidney injury in the group of patients not receiving statin therapy (about 5-10%). At the same time, it is unlikely to get a significant difference between statin dosing regimens. Risk factors such as age over 75 years, the presence of chronic kidney disease, diabetes mellitus, and chronic heart failure increase the risk of contrast-induced acute kidney injury. Conclusion Despite the significantly lower incidence of CI-AKI with intravenous contrast compared to intra-arterial, patients with CVD have a greater risk of this complication even with intravenous contrast. Therefore, the development of prevention methods and scales for assessing the likelihood of CI-AKI is an important problem. As a result of the study, we expect to conclude the benefits of statins in CI-AKI prevention and the optimal dosage regimen. This information will help us to reduce the burden of CI-AKI after CT scanning in statin naive patients with cardiovascular diseases in everyday clinical practice. ClinicalTrials.gov ID: NCT04666389

Effect of molasses based multi-nutrients and chromium supplementation on milk quality and serum biochemistry of mid and late lactating Murrah buffaloes (Bubalus bubalis)

Lactating Murrah buffaloes (28) were divided into 4 groups of 7 each to study the effect of supplement molasses based multi-nutrient containing chromium picolinate on milk quality and serum biochemistry. Basal diet comprising wheat straw, maize green and concentrate mixture were fed to all the groups. In addition to basal diet, the animals were fed 250 g molasses based multi-nutrient supplement (MMS-1), 5 mg Cr-picolinate and MMS-2 (MMS + 5 mg Cr picolinate) in groups T2, T3 and T4, respectively. Daily milk yield and monthly milk composition were recorded. Blood samples were collected from the jugular vein on days 0, 90 and 180 of experimental feeding for the estimation of serum metabolite profile, concentrations of insulin, non-esterified fatty acid (NEFA), beta-hydroxybutyric acid (BHBA), T3, T4, IGF-1, cortisol, estradiol, progesterone and Cr levels. Results have revealed that the serum Cr concentration increased in Cr supplemented groups; however, the milk Cr concentration was comparable among all the groups. Hematological parameters were statistically comparable among 4 groups except that RBC concentration was higher in group T2. Fat corrected milk (FCM), solid corrected milk (SCM), energy corrected milk (ECM) yields and milk energy contents were significantly higher in MMS supplement groups. Supplementation of MMS and Cr-picolinate had no effect on serum estradiol, NEFA, BHBA, T3, T4, cortisol and IGF-1, however, the concentration of progesterone was significantly lower in all supplemented groups. From the results, it may be deduced that the supplementation of Cr has no adverse effect on FCM yield, however, supplementation of MMS improved FCM yield by 28%. No synergistic effect of supplementation of Cr and MMS on milk composition (fat, protein, SNF, TS and lactose) was observed in lactating Murrah buffaloes.

Serum creatinine/cystatin C ratio as a case-finding tool for low handgrip strength in Chinese middle-aged and older adults

Measuring handgrip strength is the initial step to diagnose sarcopenia. To investigate whether the serum creatinine (Cr)/cystatin C (CysC) ratio could serve as a case-finding tool for low handgrip strength, we conducted a diagnostic accuracy study. Adults (aged ≥ 40 years) with normal renal function were recruited. Trained nurses collected blood samples and conducted the anthropometric measurements and handgrip strength test. The serum concentrations of Cr, CysC, and other biomarkers were measured. We recruited 1098 men and 1241 women. The Cr/CysC ratio was significantly associated with AWGS-defined low handgrip strength among men and women. The areas under the receiver operating characteristic curves were 0.79 among men and 0.78 among women for using the Cr/CysC ratio to identify AWGS-defined low handgrip strength. We set the Cr/CysC ratio cut-off values at < 8.9 among men and < 8.0 among women. The corresponding sensitivity values were 64.9% among men and 63.1% among women, while the specificity values were 83.7% among men and 77.5% among women. In conclusion, the Cr/CysC ratio is positively and linearly associated with handgrip strength and may be helpful for screening low handgrip strength in Chinese middle-aged and older adults dwelling in communities.

Modified creatinine index and risk for long-term infection-related mortality in hemodialysis patients: ten-year outcomes of the Q-Cohort Study

Modified creatinine (Cr) index, calculated by age, sex, pre-dialysis serum Cr concentration, and Kt/V for urea, is an indicator of skeletal muscle mass in hemodialysis (HD) patients. It remains unknown whether the modified Cr index predicts infection-related mortality in this population. We investigated the association between the modified Cr index and infection-related mortality. A total of 3046 patients registered in the Q-Cohort Study, a multicenter, observational study of HD patients, were analyzed. Associations between sex-specific quartiles (Q1–Q4) of the modified Cr index and the risk for infection-related mortality were analyzed by Cox proportional hazard model. During a median follow-up of 8.8 years, 387 patients died of infection. The estimated risk for infection-related mortality was significantly higher in the lower quartiles (Q1, Q2, and Q3) than in the highest quartile (Q4) as the reference group (hazard ratios and 95% confidence intervals [CI]: Q1, 2.89 [1.70–5.06], Q2, 2.76 [1.72–4.62], and Q3, 1.79 [1.12–2.99]). The hazard ratio (95% CI) for a 1 mg/kg/day decrease in the modified Cr index was 1.18 (1.09–1.27, P < 0.01) for infection-related mortality. In conclusion, a lower modified Cr index is associated with an increased risk for long-term infection-related mortality in the HD population.

Blood Management in Revision Total Hip Arthroplasty for Metal-on-Metal Devices: The Efficiency of an Intraoperative Cell Salvage System

BackgroundThe aim of this series was to investigate the efficiency of an intraoperative cell salvage system (ICS) removing metal ions during revision of metal-on-metal (MoM) devices to proof the possibility of re-transfusion of the collected blood.Materials and methodsBetween 2014 and 2018, five consecutive patients underwent revision surgery of their MoM total hip arthroplasty due to wear of the polyethylene-metal sandwich inlay or local massive metallosis with aseptic loosing of the cup. Aspiration of joint fluid of all hip prostheses was done and blood was taken to measure the metal ion concentrations, preoperatively. Perioperatively, blood was collected using an ICS before and after filtration and analyzed for Co and Cr concentrations. At that time, there was no re-transfusion of the collected and filtrated blood due to unknown metal ion concentrations.ResultsThe mean preoperative serum Co and Cr concentrations in the blood were 31.28 μg/L (range 0.22–77.47) and 17.33 μg/L (range 0.59–51.31), whereas the mean local concentrations in the aspiration fluid were 728-fold and 822-fold higher. The Co and Cr concentrations measured in the collected blood before filtration were 70.61 μg/L (range 9.40–173.00) and 337.21 μg/L (range 8.76–1383.0) and decreased markedly to average concentrations of 15.49 μg/L and 41.88 μg/L, respectively. These differences were statistically not significant (Co: p = 0.117, Cr: p = 0.175), although the mean reduction rates were 78% and 88% for Co and Cr, respectively.ConclusionThe current series showed that in case of revision of MoM hip devices, metal ions are still contained in the collected blood following filtration using a modern high-level ICS. Therefore, we would only recommend blood re-transfusion in case of low preoperative Co and Cr concentrations and sufficient renal function to warrant patients’ safety.

The Prevalence of Metabolic Acidosis in Patients with Different Stages of Chronic Kidney Disease: Single-Centre Study

Background: Metabolic acidosis (MA) is one of the most common consequences of CKD. MA is also a risk factor of CKD progression and increased mortality in these patients. Aim: The aim of this retrospective, cross-sectional study was to assess the prevalence of MA in different stages of CKD and renal replacement therapy (RRT) modalities – haemodialysis (HD) and peritoneal dialysis (PD). Additionally, the relationship between the prevalence of MA and aetiology of kidney disease was analysed. Methods: One thousand five patients in different stages of CKD, or modalities of RRT were enrolled into this single-centre cross-sectional study. Forty-one patients were ruled out because of oral bicarbonate supplementation. In the remaining 964 patients (698 CKD stages 1–5, 226 HD, 40 PD), venous blood HCO₃⁻ concentration, as well as serum Cr and urea concentrations were assessed. MA was diagnosed when blood HCO₃⁻ concentration was below 22 mmol/L. Results: The prevalence of MA increased among all stages of CKD. Patients on HD had lower prevalence of MA in comparison with CKD 5 patients with no RRT (38.5 vs. 56.0%; p = 0.02) In PD patients, the prevalence of MA was significantly lower than in HD patients (2.5 vs. 38.5%; p < 0.001). In the whole study group, there were no significant differences in the prevalence of MA between different aetiologies of CKD (glomerulonephritis 24%, hypertension 23%, diabetes 25%, and tubule-interstitial diseases 24%). Also, when only patients in stages CKD 3–5 were compared, no significant differences in the prevalence of acidosis were found (glomerulonephritis 28%, hypertension 22%, diabetes 24%, and tubule-interstitial 21%). Conclusions: (1) MA is more frequent in patients with more advanced stages of CKD. (2) RRT reduces the prevalence of MA. (3) In PD patients, MA is rare. (4) Aetiology of CKD seems not to have a significant impact on MA prevalence.

Role of HDAC3 in renal injury induced by myocardial ischemia-reperfusion in diabetic rats

Objective To evaluate the role of histone deacetylase 3 (HDAC3) in renal injury induced by myocardial ischemia-reperfusion (I/R) in diabetic rats. Methods SPF healthy adult male Sprague-Dawley rats, weighing 210-220 g, were used in this study.Diabetes mellitus was induced by intraperitoneal injection of 1% streptozotocin 60 mg/kg.Eighteen diabetic rats were divided into 3 groups (n=6 each) using a random number table method: sham operation group (group S), group I/R and HDAC3 inhibitor RGFP966 group (RG). The myocardial I/R model was established by ligation of the left anterior descending coronary artery for 30 min followed by 120-min reperfusion.RGFP966 10 mg/kg was intraperitoneally injected at 1 h before myocardial ischemia in group RG.The right internal carotid artery was isolated at 120 min of reperfusion for measurement of serum lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), creatinine (Cr) and urea nitrogen concentrations.Renal tissues were obtained for examination of the pathological changes and for determination of the expression of HDAC3, silent information regulator 1 (SIRT1) and interleukin-1β (IL-1β). The damage to the renal tubules was scored. Results Compared with S group, the serum LDH, CK-MB, Cr and urea nitrogen concentrations and renal tubular damage score were significantly increased, the expression of HDAC3 and IL-1β was up-regulated, and the expression of SIRT1 was down-regulated in group I/R (P<0.05). Compared with group I/R, the serum LDH, CK-MB, Cr and urea nitrogen concentrations and renal tubular damage score were significantly decreased, the expression of HDAC3 and IL-1β was down-regulated, and the expression of SIRT1 was up-regulated in group RG (P<0.05). Conclusion Up-regulated expression of HDAC3 is involved in renal injury induced by myocardial I/R in diabetic rats. Key words: Histone deacetylases; Diabetes mellitus; Myocardial reperfusion injury; Acute kidney injury

Effect of resveratrol on mitochondrial function in renal tubular epithelial cells of rats with sepsis-induced acute kidney injury

Objective To evaluate the effect of resveratrol on mitochondrial function in renal tubular epithelial cells of rats with sepsis-induced acute kidney injury. Methods Ninety-six healthy Sprague-Dawley rats of both sexes, aged 5-7 weeks, weighing 180-220 g, were divided into 4 groups (n=24 each) using a random number table method: sham operation group (Sham group), sepsis group (group Sep), sepsis plus vehicle group (Sep+ V group) and sepsis plus resveratrol group (Sep+ R group). Sepsis was induced by cecal ligation and puncture (CLP). Normal saline 0.5 ml, vehicle 0.5 ml and resveratrol 10 mg/kg were intraperitoneally injected at 6, 12 and 18 h after CLP in Sep, Sep+ V and Sep+ R groups, respectively.At 24 h after CLP, serum concentrations of creatinine (Cr) and blood urea nitrogen (BUN) were measured, and kidney tissues were obtained for examination of the pathological changes (using transmission electron microscopy), and the damage to the renal tubules was scored.The renal tubular epithelial cells (RTECs) were isolated from the kidney cortex at 24 h after CLP for determination of mitochondrial transmembrane potential (by flow cytometry with the fluorescent probe JC-1), intracellular ATP content, mitochondrial permeability transition pore (mPTP) opening, lipid peroxide (LPO) content, and lysosomal membrane permeability. Results Compared with group Sham, the serum concentrations of Cr and BUN, renal tubular damage score, mPTP opening, LPO content and lysosomal membrane permeability were significantly increased, and mitochondrial transmembrane potential and ATP content were decreased in Sep and Sep+ V groups (P<0.01). Compared with Sep and Sep+ V groups, the serum concentrations of Cr and BUN, renal tubular damage score, mPTP opening, LPO content and lysosomal membrane permeability were significantly decreased, and mitochondrial transmembrane potential and ATP content were increased in group Sep+ R (P<0.05). Conclusion Resveratrol improves mitochondrial function in renal tubular epithelial cells of rats with sepsis and reduces acute kidney injury, and the mechanism may be related to inhibiting oxidative stress and decreasing the lysosomal membrane permeability. Key words: Phenols; Sepsis; Acute kidney injury; Mitochondria; Kidney tubules; Epithelial cells

The 10-year outcomes of the ASR XL Acetabular System: a single-center experience from China

BackgroundThe revision rate of articular surface replacement (ASR) implants continues to rise in China because of metal debris. However, there are few reports on the clinical results of ASR implants with prolonged follow-up time in China. This study investigated the clinical outcomes and the risk factors of revision surgery in patients with ASR implants.MethodsIn total, 74 patients (74 hips) who underwent primary total hip arthroplasty (THA) with ASR implants over the past 4 to 10 years were retrospectively analyzed. Relevant clinical, radiographic, and biochemical data were examined.ResultsThe average follow-up time was 88.46 (range 23–114) months, and the ASR implants of 18 hips (24.3%) were revised. Patients who received revision surgery had worse joint function with significantly lower Harris Hip Score and Western Ontario and McMaster Universities index than non-revision patients (61.11 ± 6.68 vs 85.30 ± 9.16, p < 0.001; 61.00 ± 3.83 vs 79.04 ± 14.49, p < 0.001; respectively). Higher acetabular abduction angle and serum Co and Cr concentration were significantly relevant to worse joint function as measured by HSS (p = 0.018, 0.009, 0.043, respectively). ROC curve analysis was applied to categorize the optimal cutoff values of acetabular abduction angle and serum Cr and Co concentration for revision surgery, which were settled as 47.80°, 98.44 μg/L, and 6.95 μg/L, respectively. Overall survival of the prostheses with high acetabular abduction angle (> 47.80°, HR = 70.145, 95% CI 1.558–3158.213, p = 0.029), high serum Cr concentration (98.44 μg/L, HR = 58.956, 95% CI 1.294–2685.203, p = 0.036), and high serum Co concentration (> 6.95 μg/L, HR = 179.511, 95% CI 2.360–13656.941, p = 0.019) decreased significantly than the lower groups.ConclusionsEvaluation of the DePuy ASR XL articulation demonstrated increased rates of revision following a longer follow-up period. High acetabular abduction angle and serum Cr and Co concentration correlated with worse clinical outcomes and high revision rate. Therefore, we advocate that patients with DePuy ASR XL implants be followed up more closely than those with other implants, especially with high acetabular abduction angle and serum Cr or Co concentration.

Pharmacodynamics of cisatracurium intravenously infused during liver transplantation

Objective To evaluate the pharmacodynamics of cisatracurium intravenously infused during liver transplantation. Methods Twenty American Society of Anesthesiologists physical status Ⅲ or Ⅳ patients of both sexes, aged 18-60 yr, with body mass index of 20-30 kg/m2, scheduled for elective living donor liver transplantation, were enrolled in this study.Total intravenous anesthesia was used.The induction dose of cisatracurium for anesthesia was 0.15 mg/kg.When T1/T0 was restored to 10%, cisatracurium was injected intravenously at an initial rate of 1.5 μg·kg-1·min-1.The infusion rate was adjusted according to the monitoring results of muscle relaxation, and T1/T0 was maintained at 10%.The total amount of cisatracurium infused and infusing time were recorded during dissection phase, anhepatic phase and neohepatic phase, and the consumption of cisatracurium per unit time was calculated.Before skin incision, at 5 and 30 min of anhepatic phase, at 5 and 30 min of neohepatic phase and at the end of operation, the body temperature and stroke volume variation were recorded, blood samples were collected from the radial artery for blood gas analysis and for measurement of blood K+, Mg2+ and Ca2+ concentrations, and blood samples were collected from the internal jugular vein for determination of serum creatinine (Cr), urea nitrogen (BUN) and β2 microspheres protein (β2-MG) concentrations. Results There was no significant difference in the amount of cisatracurium per unit time between dissection phase and anhepatic phase (P>0.05). The amount of cisatracurium per unit time was significantly higher in neohepatic phase than in dissection phase and anhepatic phase (P<0.05). Compared with baseline before skin incision, blood pH value was significantly decreased at 30 min of anhepatic phase and 5 min of neohepatic phase, serum Mg2+ concentrations were decreased at 5 and 30 min of neohepatic phase and at the end of operation, the serum Cr, BUN and β2-MG concentrations were increased, the serum Ca2+ concentration was decreased at 5 min of anhepatic phase, and SVV was increased at 5 and 30 min of anhepatic phase (P< 0.05 or 0.01). Conclusion Muscle relaxation induced by cisatracurium infused intravenously in the anhepatic phase of liver transplantation is weakened. Key words: Atracurium; Liver transplantation; Infusions, intravenous; Dose-response relationship, drug